The authors would like to thank the faculty of the Radiology and Neurology Department of the SCTIMST. Susceptibility vessel sign is a very useful sign in patients with acute stroke in localizing the site of the intra-arterial thrombus. The intra-arterial thrombus contains more deoxyhemoglobin as compared to flowing blood. Deoxyhemoglobin is a paramagnetic substance whereas oxyhemoglobin is diamagnetic. Magnetic properties of hemoglobin vary according to its oxygenation status. Positive “susceptibility sign” is defined when the diameter of a hypointense vessel exceeds the diameter of the contralateral artery on SWI images. The presence of a higher concentration of deoxyhemoglobin and clot retraction makes acute intra-arterial thrombus paramagnetic, which produces a blooming artifact. SWI helps in identifying an intra-arterial thrombus. Ischemic stroke, a neurological emergency, is most commonly caused by thrombosis of the involved vessel. (e) Plain computed tomography (CT) scan shows a small hypodensity in the region of infarct (f) and (g) CT angiography axial, coronal, and sagittal maximum intensity projection images showing an abrupt cut-off of the left PICA due to thrombosis Susceptibility weighted images (c) and (d) show evidence of susceptibility blooming in the left posterior inferior cerebellar artery (PICA) which is thrombosed. įigure 1: (a) Diffusion weighted imaging and (b) apparent diffusion coefficient images showing the infarct with restriction of diffusion in the posterolateral aspect of medulla on the left side indicated by the white arrows. CT angiography performed on the next day showed cut-off in the left PICA. On SWI, there was a curvilinear hypointensity with susceptibility blooming observed along the expected course of the left PICA. Hence, a diagnosis of lateral medullary syndrome was made.
On DWI, there was a small acute infarct in the posterolateral aspect of the left medulla. An emergency MRI with stroke protocol was performed. Clinically, posterior circulation stroke was suspected. We report a patient with a classical lateral medullary syndrome in which posterior inferior cerebellar artery (PICA) susceptibility sign was very nicely demonstrated in the susceptibility weighted imaging (SWI) on magnetic resonance imaging (MRI) even before computed tomography (CT) angiography was done.Ī 41-year-old male patient, who was an occasional alcoholic and smoker, presented with complaints of sudden onset of occipital headache associated with vomiting, ataxia, hemifacial sensory loss on the left side, and blurring of vision. Susceptibility vessel sign is an important sign to localize the thrombosis in a vessel in case of ischemic stroke. Posterior inferior cerebellar artery susceptibility sign in lateral medullary syndrome.
PICA SYNDROME STROKE HOW TO
How to cite this URL: Krishna Vadana B M, Adhithyan R, Kesavadas C, Malik V. If a person with pica has an intellectual disability or mental health condition, medications for managing behavioral problems may also help reduce or eliminate their desire to eat nonnutritive items.How to cite this article: Krishna Vadana B M, Adhithyan R, Kesavadas C, Malik V. A 2000 study published in the Journal of Applied Behavior Analysis suggested that a simple multivitamin supplement may be an effective treatment in some cases. Until recently, research hasn’t focused on medications to help people with pica. Depending on your diagnosis, they may prescribe medications, therapy, or both. Your doctor may also order a psychological evaluation to determine if you have OCD or another mental health condition. For example, they’ll recommend taking regular iron supplements if you’re diagnosed with iron deficiency anemia. If your doctor thinks your pica is caused by nutrient imbalances, they may prescribe vitamin or mineral supplements. This medication may be taken by mouth, or your doctor may prescribe intravenous chelation medications for lead poisoning, such as ethylenediaminetetraacetic acid (EDTA).
This will allow you to excrete the lead in your urine. In this procedure, you’ll be given medication that binds with lead.
For example, if you have severe lead poisoning from eating paint chips, your doctor may prescribe chelation therapy. More often, the infarct is limited to a small wedge. In approximately 20 of patients, associated cerebellar infarcts are present as a result of compromise of the PICA circulation, which is in close proximity to the VA occlusive process. Your doctor will probably begin by treating any complications you’ve acquired from eating nonfood items. The lateral medullary syndrome is the most common stroke associated with intracranial VA occlusive disease.
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